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Invasive micropapillary carcinoma of the breast and bilateral ovarian mature cystic teratoma with benign Brenner tumor in a postmenopausal woman - An uncommon occurrence. INDIAN J PATHOL MICR 2024; 67:189-191. [PMID: 38358219 DOI: 10.4103/ijpm.ijpm_1207_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
The synchronous occurrence of bilateral ovarian tumors and breast malignancy often raise the suspicion of a Krukenberg tumor or a hereditary breast and ovarian cancer syndrome, both of which are uncommon in clinical practice. A 58-years-old postmenopausal woman had a right breast lump and was diagnosed as infiltrating duct carcinoma, no special type, and incidentally detected bilateral adnexal mass with the clinical suspicion of Krukenberg tumor. However, following the radical surgical excision of the right breast and bilateral ovaries, the right breast showed invasive micropapillary carcinoma (IMPC) while the ovaries showed mature cystic teratoma (MCT) with benign Brenner tumor. IMPC of the breast along with bilateral ovarian MCT with benign Brenner tumor is an unusual clinical occurrence in a postmenopausal female and thus worthy of documentation. It should be categorized as a non-hereditary synchronous tumor. The histomorphology augmented by immunohistochemistry and appropriate clinical context is pivotal in rendering a correct diagnosis.
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Borderline Brenner tumor with abnormally high serum level of carbohydrate antigen 199: a rare case report and literature review. Ir J Med Sci 2023; 192:2071-2075. [PMID: 36409423 DOI: 10.1007/s11845-022-03203-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022]
Abstract
Ovarian Brenner tumor with abnormally increased serum carbohydrate antigen 19-9 (CA19-9) level is extremely rare. A 70-year-old woman with abnormally elevated serum CA199 (1289 U/ml) found in routine physical examination. Pelvic CT and MRI scan revealed a large mass with large patches of calcification in the right adnexal area, and the patient achieved total hysterectomy and bilateral adnexectomy. Grossly, the right ovary had a solid enlargement of about 7.0 cm × 6.0 cm × 5.0 cm with irregular nodules and smooth surface and the cut surface of the mass showed that the tumor is cystic and solid. Microscopically, the tumor showed a background of fibrous tissue hyperplasia with nested and adenoid cell clusters with uniform cell size and clear boundaries. The cells were translucent with eosinophilic cytoplasm and calcification. Immunohistochemical staining showed CK7, CA125, and P63 presented diffusely strongly positive staining, while negativity for CK20, GATA3, AR, P53, and CgA. Ki-67 showed weak positive staining, about 1%. The serum CA199 level decreased significantly on the 5th day after surgery. Postoperative pathology and immunohistochemistry confirmed borderline Brenner tumor. This is the first to report a case of borderline Brenner tumor with an abnormally high serum level of CA199 before surgery. In clinical practice, the possibility of ovarian Brenner tumor should be considered when abnormal elevation of serum CA199 level cannot be reasonably explained.
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Tumor to Tumor Metastasis: A Case Report of Metastatic Angiosarcoma to an Ovarian Brenner Tumor and Review of the Literature. Int J Gynecol Pathol 2023; 42:176-181. [PMID: 35283447 DOI: 10.1097/pgp.0000000000000854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
While angiosarcoma metastatic to the ovary is rare, metastatic angiosarcoma to an ovarian tumor has never been reported in the literature, so far. We report a case of a 61-yr-old postmenopausal woman with history of breast cancer, presenting with metastatic angiosarcoma to an ovarian Brenner tumor. Initially at the frozen section examination, on limited sampling, and without knowledge of the patient's history, a diagnosis of at least proliferating Brenner tumor was rendered. Upon review of permanent sections, an intermixed angiosarcoma component was identified within Brenner tumor. Tumor to ovarian tumor metastasis is a rare phenomenon, with only 18 cases reported in the last 50 yr. It poses diagnostic challenges during sampling and histopathologic interpretation. Detailed clinical history, careful gross examination and sampling are important to recognize the separate tumor components.
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Brenner's tumour of the ovary. BMJ Case Rep 2022; 15:e249648. [PMID: 36007970 PMCID: PMC9422801 DOI: 10.1136/bcr-2022-249648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Brenner's tumour of the ovary is a rare diagnosis that is usually incidental in either clinical finding or laparotomy. Pathologically, it can be classified as being an uncommon surface epithelial tumour. Originally known as a transitional cell tumour due to its histological similarity to the urothelium, Brenner is usually an unilateral and benign tumour. The site of incidence is predominantly the ovary and can very rarely occur in other locations including the testis. The following is a case of Brenner's tumour of the ovary in a postmenopausal woman after surgical treatment, the features of which will be discussed briefly.
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[Histoseminary: Epithelial ovarian tumors - Case n o 6]. Ann Pathol 2020; 40:214-219. [PMID: 32331810 DOI: 10.1016/j.annpat.2020.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/18/2020] [Indexed: 11/30/2022]
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Abstract
A case of malignant Brenner tumor of the ovary is reported. From a survey of the literature some anatomo-clinical considerations are drawn and the histopathologic criteria for diagnosis are discussed.
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Abstract
RATIONALE Adnexal torsion is 1 of the most common emergency gynecological disease. It is more often diagnosed in reproductive age, but rarely in postmenopausal women. The clinical symptoms of adnexal torsion are nonspecific in postmenopausal women. Epithelial ovarian tumors are common in adults, and the risk of malignancy increases with age, especially after menopause. So, it is difficult to diagnose adnexal torsion precisely compared with reproductive women, and most cases of adnexal torsion with postmenopausal women are diagnosed as a malignancy preoperatively. We report a case of ovarian torsion with mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman. PATIENT CONCERNS A 65-year-old woman presented lower left abdominal pain, and there was slight abdominal distension, but no tenderness or rebound tenderness on abdominal palpation. DIAGNOSES Radiologic assessments showed a huge multiseptated cystic mass with solid portion in the left ovary, and malignancy was suspected. The test for serum tumor markers revealed normal levels of cancer antigen 125 (CA-125). INTERVENTIONS The patient underwent a laparotomy and there was torsion of the left ovary. We conducted frozen biopsy of left ovary for confirming malignancy before performing staging surgery. OUTCOMES The result of a frozen section biopsy confirmed a borderline Brenner tumor associated with a benign mucinous tumor. Subsequently, total hysterectomy and right salpingo-oophorectomy were performed. The operation was completed without addition procedures LESSONS:: Ovarian torsion is benign in most cases and malignancy is rare. Although very rare, ovarian torsion can occur in postmenopausal women, and it should be taken into consideration that the possibility of malignancy is low in postmenopausal women with normal CA-125 levels. Instead of performing staging surgery, it appears to be appropriate to carry out surgery based on the result of intraoperative frozen section biopsy so that we were able to avoid unnecessary surgical procedures.
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Laparoscopic treatment of Castleman's disease in a patient with a history of malignant Brenner tumor. Taiwan J Obstet Gynecol 2017; 55:754-756. [PMID: 27751433 DOI: 10.1016/j.tjog.2015.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2015] [Indexed: 11/20/2022] Open
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Vaginal Brenner tumor with literature review: does this tumour originate from Walthard nests? THE MALAYSIAN JOURNAL OF PATHOLOGY 2017; 39:89-93. [PMID: 28413211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Vaginal Brenner tumor is extremely rare. Only five cases have been reported in the English literature to date. Here we report a vaginal Brenner tumor in a 76-year old postmenopausal woman, who presented with a 2.5cm-sized sessile vaginal polyp. Microscopically, it showed characteristic features of Brenner tumor consisting of three components; transitional islands, glands, and dense fibrous stroma. The epithelial tumor cells were positive for GATA-3, p63 and ER, but negative for PAX8. The origin of Brenner tumors in the vagina is unclear, but previous reports suggested of Müllerian origin. However, our case revealed that vaginal Walthard nests could be possible precursor lesions based on their immunohistochemical staining results.
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Is Imprint Cytology Useful to Diagnose Malignancy for Brenner Tumors? A Case Series at a Single Institute. Acta Cytol 2017; 61:153-159. [PMID: 28231585 DOI: 10.1159/000455997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 01/10/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this study was to investigate cytological features of Brenner tumors according to tumor grade using imprint cytology. CASE Between 2004 and 2015, intraoperative imprint cytology was performed on 8 patients with Brenner tumors suspected to be malignant neoplasmas on gross examination because of their large size and solid part. These consisted of 1 benign, 3 borderline, and 4 malignant tumors. In patients with benign and borderline tumors, naked nucleus-like stromal cells and tumor cells in a sheet-like arrangement were observed against a clear background. The nuclei were round to oval-shaped with finely granular chromatin patterns and small nucleoli. Papillary cell clusters and high nucleus-to-cytoplasm ratios were only observed in 1 borderline case. In cases with malignancy, the background was necrotic. The tumor cells occurred in large papillary clusters. The nuclei showed a high degree of nuclear atypia. Nuclear grooves were present in 6 of our 8 cases and they were scant in the malignant cases. CONCLUSION Imprint cytology of Brenner tumors provided no characteristic findings to enable a definitive distinction of benign versus borderline tumors, but it enabled discrimination between malignant and other tumors. Imprint cytology can facilitate intraoperative diagnosis and aid in selecting the appropriate surgical procedure.
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Proliferative Brenner tumor of the ovary. clinicopathological study of two cases and review of the literature. EUR J GYNAECOL ONCOL 2011; 32:576-578. [PMID: 22053680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Ovarian Brenner tumors are rare epithelial tumors that account for 1%-2% of all ovarian neoplasms. They can be subdivided into benign, borderline or proliferative, and malignant neoplasms. In the vast majority of cases, these lesions are benign. Tumors of borderline malignancy are less frequent and only about 1% of Brenner tumors are malignant. We present two cases of Brenner tumors with borderline malignancy which were treated in our Department together with a review of the literature. CASES A 50-year-old, gravida 1, para 1, patient was admitted for abnormal vaginal bleeding. Clinical examination, abdominal ultrasound (US), and computed tomography (CT) revealed a cystic multilobulated tumor of the right ovary with solid elements measuring 20 x 19 x 15 cm in diameter. In the other case a 70-year-old, gravida 2, para 2, patient presented with severe urinary difficulties. Palpation revealed a mobile abdominopelvic tumor 10 x 15 in diameter. US and CT exhibited a cystic tumor with multiple solid elements and calcifications of the left ovary. Both patients underwent exploratory laparotomy. Total abdominal hysterectomy with bilateral salpingo-oophorectomy and total omentectomy were performed in both cases, while pelvic lymphadenectomy was decided only in the second case. Histologically, in both cases the diagnosis confirmed borderline Brenner tumor. CONCLUSION Although Brenner tumors are rare and the majority of them are benign, the correct histological diagnosis at frozen section with identification of the small proportion of malignant tumors, allows the extent of the operation to be adapted if needed.
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MESH Headings
- Adenocarcinoma, Clear Cell/diagnosis
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/pathology
- Brenner Tumor/diagnosis
- Brenner Tumor/pathology
- Carcinoma, Endometrioid/diagnosis
- Carcinoma, Endometrioid/pathology
- Cystadenocarcinoma, Serous/diagnosis
- Cystadenocarcinoma, Serous/pathology
- Cytodiagnosis/methods
- Diagnosis, Differential
- Endometrial Stromal Tumors/diagnosis
- Endometrial Stromal Tumors/pathology
- Female
- Humans
- Intraoperative Period
- Krukenberg Tumor/diagnosis
- Krukenberg Tumor/pathology
- Neoplasms, Germ Cell and Embryonal/diagnosis
- Neoplasms, Germ Cell and Embryonal/pathology
- Ovarian Cysts/diagnosis
- Ovarian Cysts/pathology
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/secondary
- Sex Cord-Gonadal Stromal Tumors/diagnosis
- Sex Cord-Gonadal Stromal Tumors/pathology
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[CT features of ovarian Brenner tumor and a report of 9 cases]. ZHONGHUA ZHONG LIU ZA ZHI [CHINESE JOURNAL OF ONCOLOGY] 2010; 32:359-362. [PMID: 20723434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE In order to improve the preoperative diagnostic accuracy, the computed tomographic (CT) features of ovarian Brenner tumor were described and analyzed. METHODS CT image and clinical data of nine patients with pathologically confirmed Brenner tumor were collected and analyzed retrospectively. There were 8 benign lesions and 1 borderline lesion. RESULTS All lesions in the nine cases were unilateral, round, lobulated or irregular in shape and well defined, in a mean diameter of 7.8 cm. Among the nine cases, 5 were benign tumors with uniform structure, 3 were benign tumors accompanied with other pathological components, and 1 was borderline tumor. On the CT images, the 5 uniform benign lesions showed to be solid tumor of low density (lower than that of muscle) or with small cyst inside, two of the 5 lesions had calcification, and other 2 lesions showed slightly heterogeneous enhancement after enhanced scanning. The 3 benign Brenner tumors accompanied with other pathological structures were solid-cystic or cystic, with a clear demarcation of solid and cystic components. The density of solid parts was lower than that of muscle, and slight enhancement, and one of them had calcification. The one borderline tumor was a heterogeneous solid one and its density was higher than that of muscle, with a large proportion of low density and large calcification, and moderately enhanced after enhancing. None of the 9 cases had metastasis or effusion. CONCLUSION Ovarian Brenner tumors are usually unilateral and often accompanied with other type of tumor components. When a tumor is of uniform component, the CT imaging often shows a homogeneous solid tumor with homogeneous or heterogeneous density. When a tumor is accompanied with other tumor components, it may be solid-cystic or cystic and has partial calcification. After enhancing, a benign Brenner tumor is slightly enhanced, while the borderline one is moderately/highly enhanced.
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[Tumor mass of ovary]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2008; 37:278-279. [PMID: 18844042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Abstract
AIMS To investigate p63 expression in ovarian neoplasms. METHODS AND RESULTS Immunohistochemistry using an antibody that detects all p63 isoforms was performed on 103 primary ovarian neoplasms of different histological types. Diffuse nuclear immunoreactivity of p63 was demonstrated in the 17 benign and five borderline Brenner tumours. Only one of the six malignant Brenner tumours displayed p63 expression. p63 immunoreactivity was absent in all the ovarian transitional cell carcinomas (TCC), but was demonstrated extensively in TCCs of the urinary bladder. Besides focal p63 expression in epidermal basal cells of immature and mature teratomas, all other ovarian lesions were devoid of p63 expression. p63 expression was also demonstrated in cervical transitional cell metaplasia and Walthard cell nests of fallopian tubes. CONCLUSIONS Expression of p63 protein is apparently cell lineage specific and in ovarian neoplasms is confined to benign and borderline Brenner tumours. The loss of expression in malignant Benner tumours suggests a role for p63 in Brenner carcinogenesis. The distinct patterns of p63 expression in TCCs in the ovary and urinary bladder may help in their differential diagnosis.
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Abstract
We report 10 cases of a morphologically distinct vaginal polyp which has hitherto not been characterized. The polyps occurred in women aged 39 to 78 years (most were postmenopausal) and were from 1.0 to 3.0 cm. Most of whose location is known to us were in the upper vagina. Histologically, all the polyps were remarkably similar and composed of well-circumscribed expansile nests of epithelial cells embedded in a hypocellular fibrous stroma. The epithelial elements, which were morphologically bland, were predominantly glycogenated or nonglycogenated squamous in type but small tubules were present at the periphery of some of the nests in all cases. Some of the squamous nests exhibited central necrosis with or without calcification and, in 3 cases, some contained keratin pearls. In 3 cases, a few tubules unassociated with squamous elements were present. In 3 of 4 cases tested, the cells lining the tubules were positive with prostatic acid phosphatase and in 2 of 4 with prostate-specific antigen. The epithelial elements reacted with broad-spectrum cytokeratins and cytokeratin 7 but the mesenchymal component was negative. The squamous elements were estrogen receptor positive and the mesenchymal component estrogen and progesterone receptor positive. The histologic features of this polyp, which we term "tubulo-squamous polyp of the vagina," are constant and distinctive and differ from other polyps and from mixed tumor of the vagina. Several cases reported in the literature as vaginal mixed tumor or Brenner tumor are likely examples of this entity. Possible theories of histogenesis include a Mullerian origin, derivation from mesonephric remnants or derivation from urogenital sinus-derived epithelium. Positive staining in some cases with prostatic acid phosphatase and prostate-specific antigen raises the possibility of ectopic prostatic tissue, although the overall appearance is different from that entity, or derivation from paraurethral Skene glands, the female equivalent of prostatic glands in the male.
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Three synchronized neoplasms of the female genital tract: an extraordinary presentation. Arch Gynecol Obstet 2007; 276:541-5. [PMID: 17522881 DOI: 10.1007/s00404-007-0379-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2006] [Accepted: 04/16/2007] [Indexed: 10/23/2022]
Abstract
INTRODUCTION We report a case of unusual co-existence of multiple primary neoplasms of female genital tract. CASE A 62-year-old gravida 2, para 2 was referred with spotting and vaginal discharge for about 6 months. Fractionate curettage was performed and documented endocervical squamous cell carcinoma in situ. Subsequently total abdominal hysterectomy and bilateral salphingo-oophorectomy was performed. Final pathological report demonstrated cervical squamous cell carcinoma, right ovarian Brenner tumor, left ovarian granulosa tumor and endometrial polyps. DISCUSSION Multiple primary neoplasms of female genital tract is a well-recognized yet rare occurrence. Although the presented case is probably an incidental event, the pathogenesis of the neoplastic process affecting the tissues with different embryological origin needs further research and evaluation. It is important to distinguish multiple primary neoplasms from metastatic disease because of the fact that overall survival as well as treatment would vary considerably.
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[Transitional cell tumors:malignant Brenner tumor and transitional cell carcinoma of the ovary]. AKUSHERSTVO I GINEKOLOGIIA 2007; 46 Suppl 2:20-22. [PMID: 18219757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Left ovarian Brenner tumor. JBR-BTR : ORGANE DE LA SOCIETE ROYALE BELGE DE RADIOLOGIE (SRBR) = ORGAAN VAN DE KONINKLIJKE BELGISCHE VERENIGING VOOR RADIOLOGIE (KBVR) 2005; 88:245-6. [PMID: 16302335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Ovarian Brenner tumors are uncommon neoplasms of the ovary, representing approximately 2% of all ovarian neoplasms. Nowadays there is general agreement that Brenner tumors are derived from the surface epithelium of the ovary or the pelvic mesothelium through transitional cell metaplasia. Association with other surface-derived neoplasms, either in the ipsilateral or contralateral ovary, is reported in 30% of the cases. We report a case of benign ovarian Brenner tumor and discuss the typical features on magnetic resonance imaging (MRI) and computed tomography (CT) scan as well as the differential diagnosis.
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Coexistence of brenner tumor and struma ovarii: case report. EUR J GYNAECOL ONCOL 2005; 26:109-10. [PMID: 15755015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND There has been controversy regarding the histogenesis of Brenner tumors. It is generally accepted that Brenner tumors are derived directly from ovarian surface epithelium, which undergoes metaplasia to form the typical urothelial-like components, whereas some investigators assume that Brenner tumors arise from immature germ cells. CASE We describe a well-documented case of the coexistence of struma ovarii regarded as a form of teratoma and Brenner tumor in the same ovary. Immunohistologically, not only columnar cells of thyroid follicles, but also transitional cells of Brenner nests were positive for thyroglobulin. CONCLUSIONS In the present case, Brenner tumors and thyroid elements coexisted and were positive for thyroglobulin. While there is strong evidence that pure Brenner tumors originate mostly from the ovarian surface, at least Brenner tumors associated with teratomatous elements may have a germ cell origin.
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[Malign Brenner's tumor particularities and coverage]. LA TUNISIE MEDICALE 2004; 82:701-7. [PMID: 15552031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Brenner's tumour of the ovary is rare, mostly benign. It was described for the first time by Mac-Naughton-Jones in 1898. Von Numers listed the first malign form in 1945 that represents 2 % of tumours. On the basis of a personal report and of 160 cases listed in the literature, we propose to study anatomoclinical and epidemiological elements of this hurt and to study histological particularities and various therapeutic processes. Malignant Brenner's tumour arises mostly in peri and postmenopausal period. Clinical signs are not specific. Histological exam puts the problem of the choice of the histological malignant criteria. Metastasis occurs in half of cases. They are mostly loco-regional. The treatment is essentially surgical. The efficiency of an additive treatment seems to be debatable.
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Abstract
Ovarian Brenner tumor is an uncommon epithelial tumor that accounts for 1.5% to 2.5% of all ovarian neoplasms. These tumors are usually benign. Whereas the magnetic resonance imaging features of benign Brenner tumors have been described, reports of malignant findings are limited. We report a case of borderline malignant Brenner tumor that imaged as a cystic lesion with papillary projections and solid elements.
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Primary ovarian small cell carcinoma of the pulmonary type: a case report and review of the literature. EUR J GYNAECOL ONCOL 2004; 25:239-41. [PMID: 15032292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Small cell carcinoma of the ovary is a rare type of ovarian carcinoma with a poor prognosis. Two types should be distinguished: the hypercalcemic type and the pulmonary type. We report the case history of a 54-year-old woman with both a Stage IIIC small cell carcinoma, pulmonary type and a well-differentiated endometrioid adenocarcinoma of the left ovary in combination with a Brenner tumor in the right ovary. A review of the literature on small cell carcinoma of the ovary is given and the findings of our patient are brought into perspective in terms of both histopathogenesis and treatment outcome.
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MESH Headings
- Brenner Tumor/diagnosis
- Brenner Tumor/pathology
- Brenner Tumor/therapy
- Carcinoma, Endometrioid/diagnosis
- Carcinoma, Endometrioid/pathology
- Carcinoma, Endometrioid/therapy
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/therapy
- Combined Modality Therapy
- Diagnosis, Differential
- Fatal Outcome
- Female
- Humans
- Middle Aged
- Neoplasm Staging
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/therapy
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/therapy
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Diagnosis of a small, androgenizing Brenner cell tumor in a postmenopausal woman aided by laparoscopic salpingo-oophorectomy. A case report. THE JOURNAL OF REPRODUCTIVE MEDICINE 2003; 48:381-3. [PMID: 12815914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
BACKGROUND Rapidly progressive hirsutism or virilization in the postmenopausal woman raises the suspicion of an androgen-secreting tumor. Hormonal testing and imaging studies usually rule out an adrenal tumor. However, small, androgenizing ovarian tumors may not be detectable by imaging studies. CASE A postmenopausal woman presented with rapidly progressive hirsutism and elevated androgens. Imaging studies did not localize the tumor. Bilateral laparoscopic oophorectomy was performed, and a small, androgenizing Brenner cell tumor of the left ovary was demonstrated on histologic examination. CONCLUSION Because of the low morbidity associated with laparoscopic salpingo-oophorectomy, it may be reasonable to remove the ovaries of postmenopausal women who display virilization or rapidly progressive hirsutism and elevated androgens, even if imaging studies do not detect the ovarian tumor.
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Abstract
BACKGROUND Primary lymphoma of the breast is an unusual clinical entity. Its presence with invasive breast cancer and bilateral Brenner tumors of the ovary is very rare. CASE We report a 62-year-old woman referred for further evaluation of a palpable mass in her breast. She was diagnosed and treated for simultaneous primary lymphoma of the right breast, contralateral invasive ductal carcinoma, and bilateral Brenner tumors of the ovary. One year after treatment, she is free of recurrence or progression. CONCLUSION Compared with breast carcinoma, primary breast lymphoma is a rare disease but should be considered in the differential diagnosis of breast masses. The presence of both breast malignancies presents a challenge in treatment decisions.
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Brenner tumor of the ovary with extensive stromal luteinization presenting in pregnancy: report of a case and review of the literature. J Matern Fetal Neonatal Med 2002; 12:281-3. [PMID: 12572600 DOI: 10.1080/jmf.12.4.281.283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Brenner tumor in pregnancy is rare, with only two reported cases in association with intrauterine pregnancy. A 30-year-old woman, G1P0, was found to have an adnexal mass at 15 weeks of gestation. The mass was resected at Cesarean section and found to be a Brenner tumor with areas of stromal luteinization. Brenner tumor should be considered in the differential diagnosis of adnexal masses presenting during pregnancy. The stromal luteinization was probably related to the hormonal environment of the pregnancy.
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[Malignant Brenner tumor and transitional cell ovarian carcinoma--description of two cases]. AKUSHERSTVO I GINEKOLOGIIA 2002; 42:31-3. [PMID: 11799755 PMCID: PMC2730279 DOI: 10.3201/eid0801.010174] [Citation(s) in RCA: 177] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Infections with methicillin-resistant Staphylococcus aureus (MRSA) are increasingly community acquired. We investigated an outbreak in which a food handler, food specimen, and three ill patrons were culture positive for the same toxin-producing strain of MRSA. This is the first report of an outbreak of gastrointestinal illness caused by community-acquired MRSA.
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Heterogeneous genetic alterations in ovarian mucinous tumors: application and usefulness of laser capture microdissection. Hum Pathol 2001; 32:1203-8. [PMID: 11727259 DOI: 10.1053/hupa.2001.28956] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Histologic observation of ovarian mucinous tumors suggests that there is a multistep transition through the accumulation of genetic alterations. We analyzed loss of heterozygosity (LOH) and replication error (RER) on TP53 and D17S855 as well as K-ras point mutations of the heterogeneous histologic areas of the same tumor in 26 cases of ovarian mucinous tumor. The laser capture microdissection (LCM) technique has been applied to the study of K-ras point mutation in 10 cases. As for genetic alterations for LOH or RER on TP53 and D17S855, 2 (1 borderline tumor and 1 carcinoma) of 14 cases and 4 (1 borderline tumor and 3 carcinomas) of 12 cases, respectively, showed genetic heterogeneities in different histologic areas. Six (2 borderline tumors and 4 carcinomas) of 18 cases showed heterogeneity of K-ras point mutation in the different histologic areas of the same tumor, and 5 (1 cystadenoma with Brenner tumor component, 2 borderline tumors, and 2 carcinomas) of 10 cases showed heterogeneous K-ras mutation pattern in the same tumor when the LCM technique was used. Atypical areas tended to show K-ras point mutations frequently. Out of 3 cases of mixed mucinous cystadenoma and Brenner tumor, 1 case showed K-ras point mutation in the Brenner tumor area but not in the area of mucinous cystadenoma. These preliminary results suggest that a subset of ovarian mucinous tumors occur through multistep carcinogenesis and show that LCM is useful for molecular pathologic studies.
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[Tumors of borderline malignancy or atypical proliferative tumors of the ovary?]. FOLIA MEDICA CRACOVIENSIA 2001; 41:43-52. [PMID: 11339015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Nearly sixty years have passed since Taylor first published the concept of ovarian epithelial semimalignant tumors. After confirmation of this suggestion by FIGO and WHO these tumors became the subject of analyses which helped to separate unfavourable prognostic cases in this group. We would like to present a description of basic and latest papers on borderline ovarian tumors.
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Abstract
Magnetic resonance imaging features were assessed in a benign Brenner tumor with an ipsilateral simple cyst. Brenner tumor showed isointensity to the uterine muscle on T1-weighted images and markedly low signal intensity on T2-weighted images. On the other hand, on T1-weighted images after administration of gadopentetate dimeglumine a Brenner tumor showed mild patchy enhancement. The low signal intensity seen on T1- and T2-weighted images may have been due to the abundant dense fibrous tissues.
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Abstract
PURPOSE The purpose of this study was to determine the CT and MR characteristics of Brenner tumors, rare epithelial neoplasms of the ovary. METHOD CT and MR scans of eight pathologically proven Brenner tumors of the ovary (seven benign, one malignant, and one associated with mucinous cystadenoma) were retrospectively reviewed. The masses were analyzed for location, size, external configuration, internal architecture, enhancement pattern, presence of calcification, and metastatic spread. RESULTS The patients' median age was 63 years (range 39-79 years), and the mean size of the tumors was 11.4 cm (7.5-17 cm). All tumors were unilateral and had a well-defined margin. The mass was mostly solid in three, mostly cystic in one, and "mixed" solid and cystic in four cases. The tumors with cystic components (n = 5) were mostly multilocular in appearance (n = 4). All the solid components showed mild homogeneous enhancement on postcontrast CT and MRI. Extensive amorphous calcification within the solid component on CT was seen in five of six cases (83%). No characteristic findings discriminating malignancy from benign Brenner tumor could be found. CONCLUSION Extensive amorphous calcification in a solid mass or solid component in a multilocular cystic mass is a characteristic finding of Brenner tumor of the ovary on CT and MRI.
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[Brenner tumor. Report of a case and experience at the Spanish Hospital in Mexico]. GINECOLOGIA Y OBSTETRICIA DE MEXICO 1999; 67:258-60. [PMID: 10416301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Brenner tumor is a solid benign tumor of the ovary, with its origin in the parammesonephric celomic epithelium and represents about the 0.5 an the 0.79% of all ovarian tumors. We present a case of a woman in which we found a Brenner Tumor in the left ovary while we were performing an abdominal total hysterectomy. As a consequence we reviewed the experience in the Hospital Español de México in the last 10 years. We concluded that we have the same frequency of presentation that in other parts of the world. None of our cases were malignant.
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Abstract
This study describes the appearance of Brenner tumors on MR imaging and compares quantitative signal intensity measurements of Brenner tumors with that of other ovarian tumors. A search of pathologic and MR records disclosed patients who had MRIs showing Brenner tumors prior to surgical excision. Patients (21) with other surgically proven ovarian masses were randomly selected for comparison. MR imaging was performed at 1.5 T with phased array multicoils and fast spin echo T2-weighted images. Region-of-interest measurements of signal intensity (SI) were made to calculate signal intensity ratios (SIR = mass SI/muscle SI). Brenner tumors showed significantly lower SIR than other tumors on T2-weighted images (p = 0.004) and similar SIR on T1-weighted images. Brenner tumors show lower signal intensity on T2-weighted images than other non-fibrous ovarian tumors. This lower signal intensity may result from the extensive fibrous content of these tumors.
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Cytology of ascitic fluid in a patient with metastasizing malignant Brenner tumor of the ovary. A case report. Acta Cytol 1997; 41:1299-304. [PMID: 9990262 DOI: 10.1159/000333524] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Transitional cell ("Brenner") tumors represent about 2% of all ovarian neoplasms. Brenner tumors are almost always benign. Malignant Brenner tumors of the ovary resemble urothelial carcinomas and are extremely rare. CASE A 77-year-old, white female presented with malignant Brenner tumor in both ovaries as well as lung and abdominal metastases. The cytology of the ascitic fluid revealed many activated mesothelial cells and three-dimensional cell clusters arranged in a papillary pattern. The round to oval nuclei displayed mild anisokaryosis and hyperchromasia but had a quite evenly dispersed opaque or finely granular nucleoplasm. Enfoldings of the nuclear membrane gave them the appearance of so-called coffee bean nuclei. The cytoplasm stained light bluish. CONCLUSION Knowledge of the cytologic features of ascitic fluid might allow a preoperative diagnosis of malignant, or at least proliferating, ovarian Brenner tumor.
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Doppler ultrasound in a patient with ovarian Brenner tumor of low malignant potential: comparison with Gray-scale ultrasound, magnetic resonance imaging and tumor marker suggesting malignancy. Gynecol Obstet Invest 1997; 43:135-8. [PMID: 9067723 DOI: 10.1159/000291839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We present a postmenopausal patient with giant lower abdominal tumor. Gray-scale ultrasound and magnetic resonance imaging showed typical abnormal morphology suggesting malignancy. The serum CA 125 level was 69 U/ml, and that of CA 19-9 was 2,097 ng/ml. Transvaginal color and pulsed Doppler sonography of the tumor vasculature demonstrated low peak systolic velocity (6.7 cm/s) with low pulsatility (resistance index: 0.49). Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. Histological diagnosis was ovarian Brenner tumor of low malignant potential. Transvaginal Doppler findings seemed to give specific information for the diagnosis in this case.
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Meigs' syndrome due to Brenner tumor mimicking lupus peritonitis in a patient with systemic lupus erythematosus. Am J Gastroenterol 1995; 90:657-8. [PMID: 7717331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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37
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[Value of CT scan and MRI in primary tumors of the ovary]. JOURNAL DE CHIRURGIE 1993; 130:486-91. [PMID: 8163607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Characterisation of an ovarian mass is of utmost importance in the preoperative evaluation of an ovarian neoplasm. It enables the surgeon to anticipate carcinoma of the ovary before the operation, so that adequate procedures are planned. Although, ultrasonography (US) remains the foremost imaging modality for screening patients with adnexal lesions, computed tomography (CT) recently has proved to be of value in the characterisation and management of tumors of the ovary. Magnetic resonance (MR) imaging has also been shown to have a high degree of diagnostic specificity for certain types of ovarian masses, such as dermoid cysts, and endometriomas. However, the potential of MR imaging to characterize tumors of the ovary has not yet been established. This study assesses the value of MR imaging and CT for the purpose of predicting the malignancy of ovarian lesions, and comparing findings of MR imaging with those of CT.
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[Brenner tumor of the ovary. Report of a case in a pregnant women]. MINERVA GINECOLOGICA 1992; 44:473-6. [PMID: 1436624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The Authors, after a short review on the histopathological, histogenetic and prognostic aspects, report a clinical case observed by them, in a pregnant woman. They emphasize the asymptomatic obstetric course and the accidental discovery during surgical treatment.
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Abstract
The immunoperoxidase method and an absorbed monospecific commercial rabbit anti-CEA antiserum were used to detect CEA in 105 primary ovarian tumors and 12 metastatic ovarian adenocarcinomas of intestinal origin. Primary ovarian tumors showed CEA in foci of squamous differentiation in 9 out of 10 cases of endometrioid carcinomas and focally in areas of intestinal differentiation in 21 out of 28 mucinous tumors as well as 4 out of 5 Brenner tumors. All of the serous tumors, clear cell carcinomas, and undifferentiated carcinomas as well as 19 of the 22 mucinous tumors without intestinal differentiation lacked CEA. All metastatic ovarian adenocarcinomas showed characteristic diffuse staining of CEA. Differences in CEA staining were found to be useful for histological differentiation between primary ovarian cancers and metastatic ovarian adenocarcinomas of intestinal origin. Furthermore, these data might be helpful in the selection of patients for serial CEA evaluation.
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Proliferative and malignant Brenner tumours (BT) and their differentiation from metastatic transitional cell carcinoma of the bladder: a case report and review of the literature. Eur J Obstet Gynecol Reprod Biol 1987; 26:251-60. [PMID: 3322895 DOI: 10.1016/0028-2243(87)90076-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Up to now 110 cases of malignant Brenner tumour (BT) and 45 cases of proliferative BT have been reported in the accessible literature. To delineate the diagnostic criteria and to determine the differences between these tumours and metastatic tumours of the urinary tract, 94 cases of malignant BT and 37 cases of proliferative BT were reviewed. The difficulties encountered in determining these differences are illustrated by means of a case history.
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Sonographic features of Brenner tumor of the ovary. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 1987; 6:367-372. [PMID: 3302306 DOI: 10.7863/jum.1987.6.7.367] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The sonographic findings in four patients with benign Brenner tumors of the ovary are described. Computed tomography (CT) was also obtained in one case. The neoplasms were solid, hypoechoic masses, usually exhibiting good through transmission of sound. Two neoplasms contained peripheral calcifications; one was inseparable from the uterus and was misdiagnosed as a leiomyoma; the other was well-demonstrated by CT but only in retrospect was the peripherally located calcification identified. Sonographically, Brenner tumors are similar to other solid ovarian neoplasms, particularly fibromas-thecomas, and can also be confused with pedunculated leiomyomas.
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[A case of coexistent multiple neoplasms of the female genital organs]. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 1986; 39:625-7. [PMID: 3751063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Lacto-N-fucopentaose III activity in the serum of patients with ovarian carcinoma. Gynecol Obstet Invest 1986; 21:164-8. [PMID: 3710289 DOI: 10.1159/000298948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The expression of the lacto-N-fucopentaose III (LNF III) epitope by tumor cells of the gastrointestinal tract and ovary has been observed in tissue sections with the use of the murine monoclonal antibody GA 29-1. The presence of the LNF III epitope in the circulation of patients with colorectal cancer has also been reported. In this preliminary study, we describe the presence of LNF III activity in the serum of patients with adenocarcinoma of the ovary. Twelve of 18 (66%) patients with stage I-IV disease demonstrated high reactivity to the GA 29-1 monoclonal antibody. This serum reactivity was independent of disease stage and histologic cell type. In contrast, only 1 of 6 control patients demonstrated a false-positive level of reactivity to GA 29-1. These preliminary results suggest that LNF III warrants further study of its potential application as a serum tumor marker test in patients with adenocarcinoma of the ovary.
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Abstract
In an attempt to further characterize benign, proliferating, and malignant Brenner tumors, immunoperoxidase staining for prekeratin was undertaken in a group of these neoplasms as well as in a variety of histologically different tumors of the ovary. All Brenner tumors reacted positively for prekeratin, whereas none of the other epithelial or sex cord-stromal tumors of the ovary stained. On the basis of these findings, we conclude that prekeratin might be a useful marker for differentiating malignant Brenner tumors from histologically similar, poorly differentiated ovarian neoplasms.
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[Brenner's ovarian tumour. Synopsis of clinical facts, and histological findings (author's transl)]. CESKOSLOVENSKA GYNEKOLOGIE 1982; 47:279-83. [PMID: 7094058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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47
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[Malignant Brenner tumor of the ovary--report of an autopsied case with comments on diagnosis (author's transl)]. NIHON SANKA FUJINKA GAKKAI ZASSHI 1982; 34:641-4. [PMID: 7086244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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48
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49
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[Brenner tumor]. AKUSHERSTVO I GINEKOLOGIIA 1981:6-11. [PMID: 7316092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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50
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[Brenner tumor]. AKUSHERSTVO I GINEKOLOGIIA 1981:12-4. [PMID: 7316079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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